Ask a pediatric dentist

quidditchcapn1120

Any questions?  I have about 40 minutes free time. 

suv75

What age should they be for first visit? How do I brush teeth thoroughly if LO won't stop biting the toothbrush or won't grin so I can get the bottom front teeth. I try to pull down on his lip but only sometimes works.

quidditchcapn1120

gwinnygirl:

Best way to avoid epic meltdown & screamfest when I take O to his first appointment?

Try practicing with him.  At night brush his teeth with your DH or another adult in the knee-lap position.  Talk about going to the dentist and what they will do.  Read books about going to the dentist and be POSITIVE about it.  The most fearful kids are the ones whose parents tell them they "are going to get a shot" or talk about how much they hate the dentist in front of their kids. 

Also, if that doesn't help and he still cries, know that the first appointment is fast.  With babies and toddlers, crying really just means we can see the teeth better.    Good luck!

MJN9510

DD turned 2 in september.  I was tying to switch her to the toothpaste that says for 2 years and older but not to be swallowed.  Is there any down side to keeping DD on the infant toothpaste?  She still doesnt understand the concept of not swallowing it and rinsing with water.  What do you suggest?  Also,she fights me pretty hard on brushing her teeth.  I brush her teeth in the morning and before bed but I know I am rarely getting a good brushing in.  Any tips?

ginamcp

I'm so glad you posted this - sealants for kids teeth (shamelessly stealing this question from another post yesterday).  Yay or nay? 

And ETA that one of your last Q&A posts inspired me to make an appt for C with a pediatric dentist and it went great.  She let the dentist do whatever she wanted and didn't make a peep the entire visit.   

msdrdg

suv75:

What age should they be for first visit? How do I brush teeth thoroughly if LO won't stop biting the toothbrush or won't grin so I can get the bottom front teeth. I try to pull down on his lip but only sometimes works.

 

Ditto those questions.

Also, I buy DS the OralB toothbrush (at least I'm pretty sure it's OralB) and the last one fell apart in only a few weeks.  Is there a better brand (that still has a fun character on it so he'll use it?)

hmp1

Is it gross to share toothbrushes? He likes to use mine sometimes.

quidditchcapn1120

suv75:

What age should they be for first visit? How do I brush teeth thoroughly if LO won't stop biting the toothbrush or won't grin so I can get the bottom front teeth. I try to pull down on his lip but only sometimes works.

AAPD recommends at age 1 or within 6 months of the first tooth coming in, whatever comes first.

Try a knee-lap brushing.  It usually requires two adults, but I have done it by myself on the toilet seat at times with my kiddo.  Basically have the child sit in the lap of the adult not brushing (facing them, like in the straddle position).  That adult's job is to hold the kiddo's hands and legs and comfort them.  The child's head goes in the lap of the adult doing the brushing. 

An effective way to get them to open (sounds harsh but it is easier than having to get a filling due to a cavity), is to stick a clean finger behind where the last molar should be.  It's a natural reflex to open when that happens.

rakle99

Do we need to do anything to their gums before the teeth come in?

MamatoA2010

gwinnygirl:

Best way to avoid epic meltdown & screamfest when I take O to his first appointment?

I'm eager to see the responses to this question. I brought DD in at 2 years old and it was an epic fail...

quidditchcapn1120

MJN9510:

DD turned 2 in september.  I was tying to switch her to the toothpaste that says for 2 years and older but not to be swallowed.  Is there any down side to keeping DD on the infant toothpaste?  She still doesnt understand the concept of not swallowing it and rinsing with water.  What do you suggest?  Also,she fights me pretty hard on brushing her teeth.  I brush her teeth in the morning and before bed but I know I am rarely getting a good brushing in.  Any tips?

The downside to using the infant toothpaste is that they won't be getting any topical fluoride which is the most important type of fluoride exposure (it's more effective than systemic which is what fluoride in the drinking water is for).  She can still use the regular toothpaste but use the TINIEST amount, way less than the pea sized recommendation.  Also, a few weeks ago someone posted a suggestion that I had never thought of and I can't remember who it was so I can't give credit where credit is due!  But they suggested teaching the child to spit by giving them a cup of water to spit instead of just showing them spitting.  It might help her "get it" because she can actually see the water coming out of her mouth.

 For the brushing thing, see my suggestion to suv below.  The knee-lap brushing is the best method for toddlers I think.

quidditchcapn1120

ginamcp:

I'm so glad you posted this - sealants for kids teeth (shamelessly stealing this question from another post yesterday).  Yay or nay? 

And ETA that one of your last Q&A posts inspired me to make an appt for C with a pediatric dentist and it went great.  She let the dentist do whatever she wanted and didn't make a peep the entire visit.   

Sealants- HUGE thumbs up from me.  Sealants and fluoride are the biggest advances in prevention of cavities in children.

 YAY!  I'm so happy to hear it went well!

BBrasky

What age should you go for the first visit?

 

suv75

Thanks. Looks like I'm behind. My kid is 21 months and he hasn't had his first visit. I need to get on it!

quidditchcapn1120

msd-rdg:

suv75:

What age should they be for first visit? How do I brush teeth thoroughly if LO won't stop biting the toothbrush or won't grin so I can get the bottom front teeth. I try to pull down on his lip but only sometimes works.

 

Ditto those questions.

Also, I buy DS the OralB toothbrush (at least I'm pretty sure it's OralB) and the last one fell apart in only a few weeks.  Is there a better brand (that still has a fun character on it so he'll use it?)

Honestly, I like the Oral B ones the best.  Is he chewing the bristles and that's why they fell apart?  I have BOXES and BOXES of those brushes in my house, so if you don't feel like it's creepy and want me to send you some so you have plenty of extras I would be happy to.

NotSharknado

Ds is going on 13 and has yet to get a cavity. He brushes twice a day but I feel it's only a matter of time before he gets one. Am I right or are there kids who actually don't get cavities?

quidditchcapn1120

hmp&mrj:

Is it gross to share toothbrushes? He likes to use mine sometimes.

Mouths are pretty dirty.  The bacteria that cause cavities can be shared between parents and children, siblings and children, and other children by sharing cups, toothbrushes, etc.  So, if your kid was on track to not get cavities because they didn't have the bacteria to cause cavities, but then "got" the bacteria from a caregiver or sibling, they become at higher risk to get cavities.  I often also tell parents that "sanitizing" pacifiers that fall by putting them in their mouths is a no-no.

 If you've never had a cavity though, and you're comfortable with it- go for it.

quidditchcapn1120

rakle99:

Do we need to do anything to their gums before the teeth come in?

The AAPD says you should massage their gums with a washcloth to get them used to daily oral care before their teeth come in.  I never did it with my kid and don't really pass that recommendation on a lot.  But it wouldn't hurt if you wanted to.

quidditchcapn1120

BBrasky:

What age should you go for the first visit?

 

Age 1 or within 6 months of the first tooth erupting, whichever is first, is the official recommendation. 

The Nap Taker

How do you find a good pediatric dentist? I don't know any other mom's that live near me.

quidditchcapn1120

shanado:

Ds is going on 13 and has yet to get a cavity. He brushes twice a day but I feel it's only a matter of time before he gets one. Am I right or are there kids who actually don't get cavities?

It's totally possible that he will never get one.  You have to have three things for a cavity to form:  1) the right bacteria (which some people don't have, but can be passed from people via cups, toothbrushes, etc) 2) fermentable carbohydrates (any type of sugar or carb that is eaten) and 3) time (as in time that plaque sits on your teeth, meaning poor brushing or flossing).  If any of those things does not exist in a patient's mouth= no cavity.  I have actually never had a cavity.  The first time I was ever numb was in dental school when we practiced injections and I learned a lot about what it was like to be an "actual" dental patient that day.  Sorry, I digress.

quidditchcapn1120

The Nap Taker:

How do you find a good pediatric dentist? I don't know any other mom's that live near me.

Go to aapd.org and use the lookup by zip code on the side panel.  This will also help you avoid going to a general dentist who advertises that they practice "dentistry for children" (not saying that general dentists who see children are bad, it's just hard to be transparent about specialty when people advertise like that).  Then look them up on your state dental licensing website to make sure they don't have any active investigations and google their name for reviews.  Good luck!

quidditchcapn1120

I have to catch my train, but if there are any more questions when I get home I will answer them then.  Thanks, that was fun!

quidditchcapn1120

shanado:

Ds is going on 13 and has yet to get a cavity. He brushes twice a day but I feel it's only a matter of time before he gets one. Am I right or are there kids who actually don't get cavities?

Also, kids see a huge increase in cavities when they first start driving and when they go to college, even if they've never had a cavity before.  This is because they get unrestricted access to junk food and more freedom to not necessarily practice the best oral hygiene.  Plus late nights a lot of time mean no brushing before bed.  Just something to watch out for.

argonne

A few of DS's molars have a light pink tinge to them, almost like there's blood under the surface.  What could this be?  Is it normal?  I have made an appointment for him, but it's not for two more weeks.

EMOmamma

I probably missed you but if you're still around -

It looks like DD's (7months) 3rd tooth might be a bottom incisor.  Is this a problem for any reason?  DS's teeth all came in standard order.

barnwife

shanado:

Ds is going on 13 and has yet to get a cavity. He brushes twice a day but I feel it's only a matter of time before he gets one. Am I right or are there kids who actually don't get cavities?

I am not the OP, but...I brush twice a day and have never had a cavity. So yeah, cavity-less people do exist!

Marc's Mrs.

quidditchcapn1120:

gwinnygirl:

Best way to avoid epic meltdown & screamfest when I take O to his first appointment?

Try practicing with him.  At night brush his teeth with your DH or another adult in the knee-lap position.  Talk about going to the dentist and what they will do.  Read books about going to the dentist and be POSITIVE about it.  The most fearful kids are the ones whose parents tell them they "are going to get a shot" or talk about how much they hate the dentist in front of their kids. 

Also, if that doesn't help and he still cries, know that the first appointment is fast.  With babies and toddlers, crying really just means we can see the teeth better.    Good luck!

We don't see a pediatric dentist.  Prior to DD's first real appt., our dentist had me bring DD in with me to watch me get my teeth cleaned, etc.  After my exam it was DD's turn, except it wasn't a "real" appt.  They just wanted her to get used to the chair, the tools, etc. and see that nothing scary happened.  I sat in the chair and DD sat on my lap.  She had DD "open wide" and she counted her teeth & checked them.  I think that was extremely helpful for DD.  She loves going to the dentist.

MamaKoria

When should we start teaching oral hygiene to our youngest? (4mo)

Firebolt3000

How important is it to find a dentist that is on AAPD? None of the AAPD dentists in my area accept my insurance, I'm finding it very frustrating.  I have attempted to request that some of them be added to our insurance providers list but am getting no response.   

LoveBeingAWife33008

No question.  Just wanted to say thank you

quidditchcapn1120

argonne:

A few of DS's molars have a light pink tinge to them, almost like there's blood under the surface.nbsp; What could this be?nbsp; Is it normal?nbsp; I have made an appointment for him, but it's not for two more weeks.

Three things come to mind: 1: it's just the normal color for his teeth 2: did he ever bump his teeth really hard? Fell and hit his face? Often color change in teeth is related to trauma 3: it's possible that there is a systemic issue that is affecting his enamel development. Something like amelogenesis or dentinogenesis imperfecta. That is the least likely though but the dentist will tell you for sure.

quidditchcapn1120

EMOmamma:

I probably missed you but if you're still around It looks like DD's 7months 3rd tooth might be a bottom incisor. nbsp;Is this a problem for any reason? nbsp;DS's teeth all came in standard order.

. No problem. Kid's teeth come in all sorts of wonky orders. If one that is supposed to come in doesn't come in for a long time after its supposed to, then you might make a trip to the dentist, but otherwise no worries.

quidditchcapn1120

As soon as that first tooth comes in you can start introducing the toothbrush. Toddler toothpaste is good around age 1. A very small amount of fluoride kid's toothpaste is good starting at 18 months or later. Kids can help brush but the parent should be the main brushes until the child can tie shoes on their own and even then should be checked. Flossing should be used for any teeth that you can't see between but that's pretty hard with a toddler.

ETA: I meant to quote Mamakona.

quidditchcapn1120

Firebolt3000:

How important is it to find a dentist that is on AAPD? None of the AAPD dentists in my area accept my insurance, I'm finding it very frustrating. nbsp;I have attempted to request that some of them be added to our insurance providers list but am getting no response. nbsp;nbsp;

. The AAPD is our licensing board. If a dentist that sees children is not listed as an aapd pediatric dentist, they are either right out of residency as we don't take our oral boards until 1 year after graduation, or they are a general dentist. The last possibility is that they failed boards. However, seeing a dentist period is more important than seeing a pediatric dentist. Take them where your insurance is accepted for now and check in every so often to see if a pediatric dentist accepts your insurance. What insurance is it, by the way?

july05bride2

am i too late?  my 6 y.o. has her permanent bottom teeth coming in but her baby teeth aren't loose yet?  other than wiggling her teeth, should i worry....my baby has shark teeth!

quidditchcapn1120

july05bride2:

am i too late?nbsp; my 6 y.o. has her permanent bottom teeth coming in but her baby teeth aren't loose yet?nbsp; other than wiggling her teeth, should i worry....my baby has shark teeth!

. That is actually SUPER common. If they aren't loose yet, no amount of wiggling on her part will make them come out. Her dentist will have to help wiggle them out. Good news is, those teeth are super easy to take out and it will take no time at all. Good luck!

Disneygeek77

My four year old still sucks her thumb.  What do you suggest on getting her to stop. 

Oh and I also wanted to say that I am 35 and never had a cavity either.  I brush twice a day and I am pretty sure I had sealants when I was a kid.

quidditchcapn1120

stw_77:

My four year old still sucks her thumb.nbsp; What do you suggest on getting her to stop.nbsp; Oh and I also wanted to say that I am 35 and never had a cavity either.nbsp; I brush twice a day and I am pretty sure I had sealants whennbsp;I was a kid.

. At that age I would suggest making quitting a positive thing as opposed to punitive. For example, if you stop sucking your thumb you can go with mommy to get your nails painted! Or something similar that would make her excited. Does she only do it when she is tired or all the time? Often, starting kindergarten is often a big motivator for kids. She'll notice if she's the only one doing it and usually that will make her want to stop. Good luck! Also, if she doesn't stop by age 6 or so, get a referral for an orthodontist. They have special appliances that can help break the habit if nothing else works.

Disneygeek77

quidditchcapn1120:

stw_77:

My four year old still sucks her thumb.nbsp; What do you suggest on getting her to stop.nbsp; Oh and I also wanted to say that I am 35 and never had a cavity either.nbsp; I brush twice a day and I am pretty sure I had sealants whennbsp;I was a kid.

. At that age I would suggest making quitting a positive thing as opposed to punitive. For example, if you stop sucking your thumb you can go with mommy to get your nails painted! Or something similar that would make her excited. Does she only do it when she is tired or all the time? Often, starting kindergarten is often a big motivator for kids. She'll notice if she's the only one doing it and usually that will make her want to stop. Good luck! Also, if she doesn't stop by age 6 or so, get a referral for an orthodontist. They have special appliances that can help break the habit if nothing else works.

Thanks for the advice, we will try to nail polish thing, I hope it works. 

Yes she does it all the time. 

MesmrEwe

When it comes to a general dentist, what do you suggest when the dentist is making a bigger issue out of a child's reaction than the child, and then proceeding to lecture me because I didn't want DD to have grey fillings and wanted natural colored ones instead.  DD went in for a filling and gave a mild "yelp" when they put the needle in her gums thus they (Dentist) refused to numb an additional area to finish the work that day as was originally planned and told me I "Need to talk to her about it", when I asked DD "So how'd it go?" she shrugged her shoulders and said "eh, fine, NBD"...  The dentist later came back and asked me if I talked to DD, I said, yes, and she got pithy with me because I wasn't going to push the subject further with DD (my expertise is in the field of hypnotherapy, to push the dentist's fear onto DD would have been more likely to cause a phobia down the road instead of reinforcing DD's neutral response)...  Is this a sign that I need to look for a new dentist/office for DD or am I overthinking this???